<!DOCTYPE html >
<html>

	<head>
		<meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
		<meta name="format-detection" content="telephone=no">
		<meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=no">
		<title>浙商保险 - 填写投保信息</title>
		<link type="text/css" rel="stylesheet" href="css/style.css" />
		<link type="text/css" rel="stylesheet" href="css/caninfor.css" />
		<link rel="stylesheet" type="text/css" href="css/common.css">
		<link rel="stylesheet" type="text/css" href="css/property_thress.css">
		<link rel="stylesheet" type="text/css" href="css/city-picker.css">
		<script type="text/javascript" src="js/jquery-1.9.1.js"></script>
		<script type="text/javascript" src="js/date.js"></script>
		<script type="text/javascript" src="js/iscroll.js"></script>
		<script type="text/javascript">
			$(function() {
				$('#beginTime').date();
				$('#endTime').date({
					theme: "datetime"
				});
			});
		</script>
		<script src="js/ui-choose.js"></script>
		<script src="js/style.js"></script>
		<script src="js/city-picker.data.js"></script>
		<script src="js/city-picker.js"></script>
	</head>

	<body>
		<form action="" method="get">
			<div class="menages"><i></i>投保人信息</div>
			<div class="basic manager-div margin-b5">
				<div class="title_text">
					姓名
					<input type="text" value="请填写投保人姓名" onFocus="if(value==defaultValue){value='';}" onBlur="if(!value){value=defaultValue;}">
				</div>
				<div class="title_text">
					身份证号
					<input type="text" maxlength="18" value="请填写身份证号" onFocus="if(value==defaultValue){value='';}" onBlur="if(!value){value=defaultValue;}">
				</div>
				<div class="title_text">
					电子邮箱
					<input type="text" value="请填写电子邮箱" onFocus="if(value==defaultValue){value='';}" onBlur="if(!value){value=defaultValue;}">
				</div>
				<div class="title_text">
					手机号码
					<input type="tel" maxlength="11" value="请填写手机号码" onFocus="if(value==defaultValue){value='';}" onBlur="if(!value){value=defaultValue;}">
				</div>
			</div>
			<div class="menages"><i></i>被保险人信息</div>
			<div class="basic manager-div margin-b5">
				<div class="title_text">
					与投保人关系
					<select name="rdate" class="select">
						<option selected="selected">本人</option>
						<option>其他</option>
					</select>
				</div>
				<div class="title_text">
					姓名
					<input type="text" value="请填写投保人姓名 " onFocus="if(value==defaultValue){value='';}" onBlur="if(!value){value=defaultValue;}">
				</div>
				<div class="title_text">
					身份证号
					<input type="text" maxlength="18" value="请填写身份证号 " onFocus="if(value==defaultValue){value='';}" onBlur="if(!value){value=defaultValue;}">
				</div>
				<div class="title_text">
					手机号码
					<input type="tel" maxlength="11" value="请填写手机号" onFocus="if(value==defaultValue){value='';}" onBlur="if(!value){value=defaultValue;}">
				</div>
			</div>
			<div class="menages"><i></i>保险标的信息</div>
			<div class="basic manager-div margin-b5">
				<div class="title_text">
					保险房屋地址
					<div class="city-city" id="distpicker">
						<div class="form-group">
							<div style="position: relative;">
								<input id="city-picker3" class="form-control" readonly type="text" value="浙江省/杭州市/拱墅区" data-toggle="city-picker">
							</div>
						</div>
					</div>
				</div>
				<div class="title_text">
					详细地址
					<input type="text" value="请填写详细地址 " onFocus="if(value==defaultValue){value='';}" onBlur="if(!value){value=defaultValue;}">
				</div>
				<div class="title_text">
					房屋结构
					<div style="width: 70%; float: right;">
						<ul class="fam-choose" id="uc_01">
							<li>砖混结构</li>
							<li class="selected">钢筋混凝土结构</li>
						</ul>
					</div>
				</div>
			</div>
			<div class="menages"><i></i>保险起期</div>
			<div class="basic manager-div margin-b5">
				<div class="title_text">
					保险起期
					<div class="demo">
						<div class="lie"><input id="beginTime" class="kbtn select-srea" placeholder="请选择保险开始时间" /></div>
					</div>
					<div id="datePlugin"></div>
				</div>
			</div>
			<div class="height44"></div>
			<div class="U-login-con">
				<a class="U-user-login-btn" ontouchstart="this.className='U-user-login-btn2'" ontouchend="this.className='U-user-login-btn'">下一步</a>
				<div class="DialogDiv" style="display:none; ">
					<div class="U-guodu-box">
						<div>
							<table width="100%" cellpadding="0" cellspacing="0" border="0">
								<tr>
									<td align="center">
										<img src="images/ICBCLoading.gif">
									</td>
								</tr>
							</table>
						</div>
					</div>
				</div>
				<div class="cl"></div>
			</div>
		</form>
		<script src="js/quote.js"></script>
	</body>

</html>